The development and content validation of an injured worker stigma scale

Abstract

Individuals who experience workplace injuries or illnesses also experience societal stigma related to their injured identity. Such stigmatization takes place in the form of stereotyping, prejudice from others, and unethical actions and often occurs in multiple facets of an injured worker’s life. The injured worker can also internalize the pervasive stigma; self-stigmatization has been linked with adverse outcomes such as reduced help-seeking, increased shame, impeded recovery, raised stress levels, lowered self-efficacy. However, there is currently no reliable measure that accurately measures internalized stigma within injured workers. The current study generated an initial item pool based on content from within the stigma and injured worker literatures as well as interviews with six injured workers. Seven knowledgeable individuals assessed the relevance and representativeness of the items. Item-level content validity index values ranged from .14 to 1.00 (.09 to 1.00 when corrected for chance agreement with Polit’s modified kappa). Qualitative feedback indicated a need for simplified language, trauma informed questions, and further emphasis on the structural nature of stigma. Given this feedback and a scale-level content validity index value of .55, further revisions are needed to develop a valid measure of internalized injured worker stigma.